Although the injury rate of yoga is low, nearly two-thirds of musculoskeletal injuries in yoga affect the lower extremity: a systematic review

Abstract

ImportanceYoga is a very popular sporting activity across the world. There is limited information on the epidemiology and characteristics of yoga-related injuries.ObjectiveTo determine the incidence and prevalence of musculoskeletal injuries sustained in yoga.Evidence reviewA systematic review was registered with PROSPERO and performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and checklist. Level I–IV evidence studies reporting the incidence and prevalence of musculoskeletal injuries in male and female yoga practitioners were eligible for inclusion. The number and types of injuries were extracted from each study. Duplicate patient populations within separate distinct publications were analysed and reported only once. Injury rates were recorded and calculated on the basis of gender and nature of injury. Incidence was defined as the number of injuries sustained over a specific time duration. Prevalence was defined as the proportion of subjects with an injury at a given point in time.FindingsFive studies were analysed that reported injury incidence or prevalence in yoga (7453 subjects). In four of these studies, the type of yoga was not specified, but Mikkonen et al focused solely on Ashtanga Vinyasa practitioners. There were 6544 female (88%) and 909 male (12%) yoga practitioners analysed (49.1±13.6 years of age). The incidence of injury among yoga practitioners was 1.18 injuries per 1000 yoga hours. Only four studies provided prevalence data, displaying 6.6% injury prevalence in 7415 yoga practitioners overall (up to 62% in Ashtanga Vinyasa). Overall, lower extremity injuries comprised 64% of total injuries; specifically the hip, hamstring, knee, ankle, feet and toe. The upper extremity and head and trunk injuries account for 13% and 23%, respectively.Conclusions and relevanceThere is limited quantity heterogeneous evidence reporting the characteristics of yoga injuries. The overall injury incidence is 1.18 injuries per 1000 yoga hours. The prevalence of injury is poorly characterised. However, the weighted mean prevalence is 7%. The majority of yoga injuries are lower extremity injuries.Level of evidenceLevel IV, a systematic review of level I–IV studies.